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Cardiac anaesthesia

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https://www.readbyqxmd.com/read/28710899/effects-of-dobutamine-dopamine-phenylephrine-and-noradrenaline-on-systemic-haemodynamics-and-intestinal-perfusion-in-isoflurane-anaesthetised-horses
#1
C Dancker, K Hopster, K Rohn, S B Kästner
BACKGROUND: In the horse, effects of cardiovascular-active drugs on local perfusion of the gastrointestinal tract are poorly understood. OBJECTIVES: To determine the effect of drugs commonly used to support blood pressure, on local intestinal blood flow and tissue oxygenation under isoflurane anaesthesia. STUDY DESIGN: In vivo randomised crossover experiment METHODS: Ten horses were anaesthetised with isoflurane. After 90 minutes of equilibration three doses (μg/kg bwt/min) of dobutamine (DOB 0...
July 15, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28692337/a-multidisciplinary-perioperative-strategy-for-attaining-more-physiologic-cardiac-surgery
#2
Kyriakos Anastasiadis, Polychronis Antonitsis, Apostolos Deliopoulos, Helena Argiriadou
BACKGROUND: Cardiac surgery is, by definition, a "non-physiologic" intervention associated with systemic adverse effects. Despite advances in surgical technique, cardiopulmonary bypass (CPB) technology as well as anaesthesia management and patient care, there is still significant morbidity and subsequent mortality. AIM: We consider that the contemporary demand for further improving patient outcome mandates the upgrade from optimal perfusion during the procedure as the gold standard to the concept of a "more physiologic" cardiac surgery...
March 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28675953/utility-of-nociceptive-flexion-reflex-threshold-and-bispectral-index-to-predict-movement-responses-under-propofol-anaesthesia
#3
Axel Jakuscheit, Matthias J Posch, Stefanos Gkaitatzis, Lisa Neumark, Mark Hackbarth, Martin Schneider, Gregor Lichtner, Jan H Baars, Falk von Dincklage
INTRODUCTION: The nociceptive flexion reflex threshold (NFRT) is a promising tool to monitor analgesia during general anaesthesia. Clinical studies have shown that the NFRT allows to predict movement responses to painful stimuli under a combined anaesthetic regime of sedative and opioid agents. Experimental studies indicated that the NFRT is also able to predict such movement responses under an exclusively sedative regime like propofol mono-anaesthesia. Therefore, we performed this study to investigate the ability of the NFRT to predict movement responses to painful stimuli in patients during a clinical propofol mono-anaesthesia...
June 2017: Somatosensory & Motor Research
https://www.readbyqxmd.com/read/28672091/young-children-with-severe-congenital-malformations-vacterl-expressed-mixed-feelings-about-their-condition-and-worries-about-needles-and-anaesthesia
#4
A-M Kassa, G Engvall, H Engstrand Lilja
AIM: Our knowledge of the perceptions that children with severe congenital malformations have of their health, treatment and how to improve hospital care is limited. This study focused on patients with vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies and limb abnormalities (VACTERL). METHODS: We interviewed 10 children aged 5-8 years with VACTERL association who were treated in a Swedish tertiary paediatric surgical centre in 2015 and 2016, by using a computer-assisted technique called In My Shoes...
July 3, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28651993/evaluation-of-bleeding-risk-in-patients-on-anticoagulation-for-mechanical-cardiac-valve-operated-for-benign-prostatic-obstruction
#5
S Gardic, V Misrai, A R Azzouzi, A Campeggi, J-N Cornu, A De La Taille, S Lebdai, R Mathieu, G Robert, A Descazeaud
OBJECTIVE: To evaluate bleeding risk in patients on anticoagulation for mechanical cardiac valve operated for benign prostatic obstruction (BPO). MATERIAL AND METHOD: Fifty-eight patients operated between 1998 and 2014, in seven French departments of Urology were included. Forty-five patients were operated by conventional surgery (transurethral resection of the prostate 38, open simple prostatectomies 7), and 13 patients were operated by Greenlight™ photovaporization of the prostate (PVP)...
June 23, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28625437/inhalation-versus-intravenous-anaesthesia-for-adults-undergoing-on-pump-or-off-pump-coronary-artery-bypass-grafting-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
REVIEW
Regina El Dib, José E Guimarães Pereira, Arnav Agarwal, Huda Gomaa, Ana Patricia Ayala, Andresa Graciutti Botan, Leandro Gobbo Braz, Luciane Dias de Oliveira, Luciane Cruz Lopes, Preethy J Mathew
STUDY OBJECTIVE: To compare the use of inhalation versus intravenous anaesthesia for adults undergoing on-pump or off-pump coronary artery bypass grafting. DESIGN: A systematic review. SETTING: A hospital-affiliated university. MEASUREMENTS: The following databases were searched: the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 10), MEDLINE, EMBASE, and LILACS (from inception to October 2016). We used the GRADE approach to rate overall certainty of the evidence...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28600851/neonatal-surgery-in-a-developing-country-outcome-of-co-ordinated-interdisciplinary-collaboration
#7
Sebastian O Ekenze, Victor O Modekwe, Obinna V Ajuzieogu, Isaac O Asinobi, Jubril Sanusi
AIM: Neonatal surgery in low-income and middle-income countries has a poorer outcome when compared with high-income countries. This study evaluated the management challenges and outcomes of neonatal surgery before and after the introduction of focused interdisciplinary team management in 2013. METHODS: We retrospectively analysed neonatal surgery undertaken at two referral hospitals in Enugu, south-eastern Nigeria from January 2011 to November 2015. Cases managed prior to July 2013 (group A) were compared with those managed from July 2013 (group B)...
June 10, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28586614/frequency-indications-and-complications-of-pulmonary-artery-catheter-insertion-in-adult-open-heart-surgery-patients-of-a-tertiary-care-hospital
#8
Syed Shabbir Ahmed, Mohammad Irfan Akhtar, Rehana Kamal
BACKGROUND: Patients presenting for cardiac surgery have unstable cardiovascular disease and haemodynamics with multiple coexisting diseases. Optimal monitoring in the perioperative period is very important for best perioperative outcome. The introduction of the flow-directed pulmonary artery catheter (PAC) into clinical practice is one of the most important and popular advances in the field of cardiac anaesthesia. The objective of the study was to determine the frequency, indications and complications of pulmonary artery catheter insertion in adult open-heart surgery patients...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28576285/intraoperative-ketamine-for-prevention-of-postoperative-delirium-or-pain-after-major-surgery-in-older-adults-an-international-multicentre-double-blind-randomised-clinical-trial
#9
Michael S Avidan, Hannah R Maybrier, Arbi Ben Abdallah, Eric Jacobsohn, Phillip E Vlisides, Kane O Pryor, Robert A Veselis, Hilary P Grocott, Daniel A Emmert, Emma M Rogers, Robert J Downey, Heidi Yulico, Gyu-Jeong Noh, Yonghun H Lee, Christine M Waszynski, Virendra K Arya, Paul S Pagel, Judith A Hudetz, Maxwell R Muench, Bradley A Fritz, Witold Waberski, Sharon K Inouye, George A Mashour
BACKGROUND: Delirium is a common and serious postoperative complication. Subanaesthetic ketamine is often administered intraoperatively for postoperative analgesia, and some evidence suggests that ketamine prevents delirium. The primary purpose of this trial was to assess the effectiveness of ketamine for prevention of postoperative delirium in older adults. METHODS: The Prevention of Delirium and Complications Associated with Surgical Treatments [PODCAST] study is a multicentre, international randomised trial that enrolled adults older than 60 years undergoing major cardiac and non-cardiac surgery under general anaesthesia...
July 15, 2017: Lancet
https://www.readbyqxmd.com/read/28552594/plasma-concentration-and-cardiovascular-effects-of-intramuscular-medetomidine-combined-with-three-doses-of-the-peripheral-alpha2-antagonist-mk-467-in-dogs
#10
Flavia Restitutti, M Johanna Kaartinen, Marja R Raekallio, Otto Wejberg, Emmi Mikkola, Jerome R E Del Castillo, Mika Scheinin, Outi M Vainio
OBJECTIVE: We investigated the plasma concentrations and cardiovascular effects of intramuscularly (IM) administered medetomidine, administered alone or with three different doses of MK-467. STUDY DESIGN: Prospective, randomized, open, crossover trial. ANIMALS: Eight purpose-bred healthy Beagle dogs. METHODS: Each dog was administered four treatments: medetomidine 20 μg kg(-1) IM alone or mixed in the same syringe with MK-467 (200 μg kg(-1), 400 μg kg(-1) or 600 μg kg(-1))...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28548279/significant-decreases-in-blood-propofol-concentrations-during-adrenalectomy-for-phaeochromocytoma
#11
Tatsunori Watanabe, Haruhiko Hiraoka, Takuya Araki, Daisuke Nagano, Tohru Aomori, Tomonori Nakamura, Koujirou Yamamoto, Hiroshi Baba
AIM: The kinetics of propofol are influenced by cardiac output. The aim of this study was to examine changes in blood propofol concentrations during phaeochromocytoma surgery using target-controlled infusion (TCI) anaesthesia with propofol. METHODS: This is a prospective observational study. Ten patients with phaeochromocytoma who underwent unilateral adrenalectomy were included. Cardiac output was measured using an arterial pressure-based cardiac output analysis method...
May 26, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28537937/dexmedetomidine-the-new-all-in-one-drug-in-paediatric-anaesthesia
#12
Cedric E Sottas, Brian J Anderson
PURPOSE OF REVIEW: Dexmedetomidine is a drug with sedative, anxiolytic, sympatholytic and analgesic properties, which is finding widespread practice in paediatric anaesthesia and related practices. The present review summarizes its pharmacology and current experience with the drug. RECENT FINDINGS: Dexmedetomidine is proving useful in many diverse areas in paediatric anaesthesia where its sedative properties are useful for premedication, fibreoptic intubation and radiologic procedures...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28537454/transfusion-requirements-in-elective-cardiopulmonary-bypass-surgery-patients-predictive-value-of-multiplate-and-thromboelastography-teg-platelet-mapping-assay
#13
Praleene Sivapalan, Anne Caroline Bäck, Sisse Rye Ostrowski, Hanne Berg Ravn, Pär Ingemar Johansson
Managing haemostasis in patients undergoing cardiopulmonary bypass (CPB) surgery remains a challenge. There is no established laboratory test to predict transfusion requirements in cardiac surgery. We investigated whether preoperative Thromboelastography (TEG) with Platelet Mapping Assay (PMA) or Multiple Electrode Aggrometry (MEA) could predict transfusion requirements in patients undergoing elective coronary artery bypass grafting (CABG) or combined CABG with aortic or mitral valve replacement. We prospectively investigated 199 patients undergoing elective CABG or combined procedures...
May 24, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28510739/comparison-of-preoperative-and-intraoperative-assessment-of-aortic-stenosis-severity-by-echocardiography
#14
Y Uda, B Cowie, R Kluger
Background: General anaesthesia and surgically induced changes in cardiac loading conditions may alter flow across the aortic valve. This study examined how echocardiographic assessment of the severity of aortic stenosis (AS) changes during surgery. Methods: Patients who underwent aortic valve replacement for any severity of AS between July 2007 and June 2015 were identified. Peak velocities, mean gradients, and dimensionless indices (DI) measured with preoperative transthoracic echocardiography (TTE) were compared with those measured with intraoperative transoesophageal echocardiography (TOE)...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28509399/association-of-renin-angiotensin-antagonists-with-adverse-perioperative-events-in-patients-undergoing-elective-orthopaedic-surgery-a-case-control-study
#15
Amith Zainudheen, Ian A Scott, Xenia Caney
BACKGROUND: Renin angiotensin antagonists (RAAs) may block protective vasopressor responses during surgery. Evidence linking RAAs with intraoperative hypotension and perioperative adverse events is conflicting. METHODS: Retrospective case-control study of 258 consecutive patients who underwent elective total knee or hip replacement between January 1(st) 2013 and August 31(st) 2016, and who were chronically prescribed a single blood pressure lowering agent up to the time of surgery...
May 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28501797/predictors-of-procedural-complications-in-adult-fontan-patients-undergoing-non-cardiac-procedures
#16
Alexander C Egbe, Arooj R Khan, Naser M Ammash, David W Barbara, William C Oliver, Sameh M Said, Emmanuel Akintoye, Carole A Warnes, Heidi M Connolly
OBJECTIVE: Limited data exist regarding the outcomes of non-cardiac procedures (NCPs) in adult patients after Fontan operations (Fontan patients). METHODS: To compare procedural outcomes after NCPs in Fontan patients with outcomes for two matched control groups: patients with repaired congenital heart disease and biventricular circulation (CHD-BiV) and patients with no heart disease (NHD). We defined cyanosis as oxygen saturation <90% and procedural hypoxia as saturation <80% or a decrease in saturation >10% from baseline...
May 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28501489/hydroxyethyl-starch-130-0-4-compared-with-0-9-nacl-administered-to-greyhounds-with-haemorrhagic-shock
#17
Duana McBride, Anthea L Raisis, Giselle Hosgood, Lisa Smart
OBJECTIVE: To determine the cardiovascular and acid-base effects of 6% hydroxyethyl starch (HES) 130/0.4 and 0.9% sodium chloride (NaCl) administered to anaesthetized greyhounds with haemorrhagic shock. STUDY DESIGN: Prospective, experimental, complete randomized block design. ANIMALS: Twelve healthy adult greyhounds. METHODS: After 60 minutes of isoflurane anaesthesia, 48 mL kg(-1) of blood was removed to induce hypotension...
March 6, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28498903/efficacy-and-safety-of-inhaled-anaesthetic-for-postoperative-sedation-during-mechanical-ventilation-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#18
J Spence, E Belley-Côté, H K Ma, S Donald, J Centofanti, S Hussain, S Gupta, P J Devereaux, R Whitlock
The aim was to evaluate the efficacy and safety of volatile anaesthetic for postoperative sedation in adult cardiac surgery patients through a systematic review and meta-analysis. We retrieved randomized controlled trials from MEDLINE, EMBASE, CENTRAL, Web of Science, clinical trials registries, conference proceedings, and reference lists of included articles. Independent reviewers extracted data, including patient characteristics, type of intraoperative anaesthesia, inhaled anaesthetic used, comparator sedation, and outcomes of interest, using pre-piloted forms...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28486575/burst-suppression-ratio-underestimates-absolute-duration-of-electroencephalogram-suppression-compared-with-visual-analysis-of-intraoperative-electroencephalogram
#19
W G Muhlhofer, R Zak, T Kamal, B Rizvi, L P Sands, M Yuan, X Zhang, J M Leung
Background: Machine-generated indices based on quantitative electroencephalography (EEG), such as the patient state index (PSI™) and burst-suppression ratio (BSR), are increasingly being used to monitor intraoperative depth of anaesthesia in the endeavour to improve postoperative neurological outcomes, such as postoperative delirium (POD). However, the accuracy of the BSR compared with direct visualization of the EEG trace with regard to the prediction of POD has not been evaluated previously...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28472245/beta-blocker-subtype-and-risks-of-perioperative-adverse-events-following-non-cardiac-surgery-a-nationwide-cohort-study
#20
Mads E Jørgensen, Robert D Sanders, Lars Køber, Kala Mehta, Christian Torp-Pedersen, Mark A Hlatky, Jannik L Pallisgaard, Richard E Shaw, Gunnar H Gislason, Per F Jensen, Charlotte Andersson
Aims: Beta-blockers vary in pharmacodynamics and pharmacokinetic properties. It is unknown whether specific types are associated with increased perioperative risks. We evaluated perioperative risks associated with beta-blocker subtypes, overall and in patient subgroups. Methods and results: We performed a Danish Nationwide cohort study, 2005-2011, of patients treated chronically with beta blocker (atenolol, bisoprolol, carvedilol, metoprolol, propranolol, or other) prior to non-cardiac surgery...
May 2, 2017: European Heart Journal
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